Why I chose to specialize in Dermatology

Today, I thought I’d write a post about why I chose to specialize in Dermatology. This will probably be the first post in a 2 or 3 post series about specializing in dermatology in Singapore. In the upcoming posts, I will write more about how to match in the dermatology residency program in Singapore and also what the residency program is like, so look out for that!

Before we dive in, if you are new here, HI! I am Xiaotian and I am currently a first year senior resident in the national Dermatology residency program in Singapore. I started this personal website/blog many moons ago as a way to share more about the things I am passionate about, such as travel, photography and technology. In the future, I also plan to write more about my experiences working in the healthcare sector in Singapore. Now, back to our topic for the day!

What is Dermatology?

Allow me to start by clarifying some common perceptions and misconceptions about dermatology. Dermatology is the study of skin diseases. It is different from Aesthetic Medicine, which focuses mainly on performing aesthetic procedures and diagnosing and managing common skin conditions such as acne, scars and age spots. While dermatologists are also trained to do these aesthetic procedures and manage these common skin conditions, they are also equipped with the knowledge and experience to diagnose and manage rarer and more complex skin conditions (such as blistering diseases).

Another common misconception is that skin diseases are just skin deep. While that may be true for common skin conditions such as eczema or acne, sometimes rashes on the skin might be the first sign of a more serious condition that can affect many organs within the body, such as systemic lupus erythematosus (SLE or lupus). Moreover, poorly controlled skin diseases can be disfiguring and severely afflict one’s self esteem and even lead to other health issues such as anxiety or depression. So I would definitely say that skin diseases are not skin deep and certainly not something to dismiss.

Why I chose to specialize in Dermatology

With that out of the way, I would like to share 3 reasons why I chose to pursue dermatology as my medical specialization.

1. Dermatology is a fascinating field!

I can wax poetic about the fascinating nature of dermatology all day but let me try to keep it short. There is great variety as patients can present with a myriad of different rashes and growths. Dermatology is also a wide encompassing specialty which requires knowledge of many other specialities because, as alluded to earlier, skin diseases are often more than skin deep and can be the first sign of a systemic illness. Moreover, dermatology is also a highly visual and clinical field and a good dermatologist often does not need to rely heavily on laboratory investigations. There are also many treatment modalities ranging from topical creams to oral medications to new biologics to phototherapy to surgery and lasers and many more. There is always something new to learn everyday about this ever evolving and expanding subject!

2. The dermatologist can do everything!

Another appealing aspect of dermatology is the fact that the dermatologist is equipped with the skillset to manage patients without consulting other specialists. Dermatologists in Singapore are also trained to perform skin surgery as well as in dermatopathology (the examination of skin diseases under microscope). This means that if a patient with a skin growth sees a dermatologist, the dermatologist is able to diagnose the growth, surgically remove the growth for examination under microscopy and also report the pathology after examining it under microscope. This unique combination of medical, surgical and pathology expertise cannot be found in any other specialty.

3. Work life balance is important.

Lastly, I treasure work life balance and dermatology is a field where there is some semblance of work life balance. Dermatology is predominantly an outpatient service and dermatological emergencies are rare. This means I don’t have to wake up at an ungodly hour and I don’t get calls from the hospital in the middle of the night often. And more often than not, I get my golden weekends (i.e. both Saturday and Sunday are rest days, which is definitely hard to come by in the healthcare field). However, don’t mistake this for a slack life- a lot of the extra free time is spent on academic activities such as studying and doing research. But I do appreciate having some extra time and energy to do the things I love and to spend with my loved ones!

Dermatology is not for everyone

With all that being said, dermatology is definitely not for everyone. Many friends and colleagues have often asked how I look at rashes without feeling squeamish or itchy. Some people also dislike a predominantly ambulatory practice and prefer to take care of patients in the ward or critically ill patients. Others prefer standing at the operating theatre and performing long surgeries. All in all, if you are medical student or junior resident stumbling across this post while wondering what to do with your life, the most important thing about choosing your future specialty is to pick something you are truly passionate in. And if you are passionate about dermatology as well, keep your eyes peeled as I will share more about how to match into dermatology residency here in Singapore.

Take care and until the next time!

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